Psychometric Evaluation of the Persian Version of Spiritual Self-Care Practice Scale in Iranian Patients with Cancer.

Spiritual self-care is defined as a set of patient-centered or family-centered spiritual activities aimed at promoting health and well-being. In chronic diseases such as cancer, the responsibility for care typically falls on the patient or their family, necessitating an accurate assessment of the patient's self-care practices to achieve this goal. The objective of this study was to translate, culturally adapt, and examine the psychometrics of the Persian version of the spiritual self-care practice scale (SSCPS) in cancer patients. This scale is designed to be administered directly to patients to assess their spiritual self-care practices. This cross-sectional study was conducted at the oncology ward in Afzalipoor Hospital, Javad Al-Aemeh Clinic, and Physicians Clinics affiliated with Kerman University of Medical Sciences in Kerman, southeast Iran. The study included qualitative and quantitative assessments of face validity, content validity, item analysis, exploratory and confirmatory factor analysis (construct validity), and reliability. Data collection took place between March 20, 2023, and December 30, 2023. The scale's content validity index was calculated to be 0.948, with mostly minor revision comments for most items. The item-content validity indices ranged from 0.7 to 1. Exploratory factor analysis revealed a five-factor solution with 23 items, explaining 61.251% of the total variance. The identified factors were labeled as 'personal and interpersonal spiritual practices,' 'shaping and strengthening relationship practices,' 'religious practices,' 'physical spiritual practices,' and 'reshaping relationship practices.' Most of the confirmatory factor analysis indices were satisfactory (χ2/df = 1.665, CFI = 0.934, IFI = 0.935, RMSEA = 0.058). The Cronbach's α coefficient for the total scale was 0.89, while it ranged from 0.596 to 0.882 for the subscales. The Persian version of SSCPS with 23 items demonstrates reliability and effectiveness in assessing the spiritual practice performance of Iranian cancer patients. Compared to the original version, the Persian adaptation of SSCPS is concise, making it a suitable instrument for future research and practice on spiritual self-care among Iranian cancer patients.

Cross-national comparative study of orphan drug policies in Saudi Arabia, the United States, and the European Union.

Background: Rare diseases are chronic, serious, and life-threatening conditions that have not received sufficient attention from drug developers due to their rarity. Policies have been implemented to encourage research and incentivize the development of orphan drugs. However, the implementation of these policies has been inconsistent worldwide. Objective: The primary aim of this study was to compare orphan drug policies in the United States, Europe, and Saudi Arabia (SA) and assess their impact on the number of approved indications. Method: Lists of all drugs granted orphan designations and authorized for marketing in the United States, European Union, and SA were extracted using orphan drug lists available in regulatory body databases. The availability of these drugs, regarding their approval for orphan indication and designation, was assessed and classified using Anatomical Therapeutic Chemical codes. Result: A total of 792 orphan drug designations with at least one authorized indication were identified in this study. Of these, 92% were designated by the Food and Drug Administration (FDA), and 27% were designated by the European Medicine Agency (EMA). The FDA, EMA, and Saudi Food and Drug Authority approved 753, 435, and 253 orphan drugs, respectively. Conclusion: Fewer orphan drug approvals were found in SA than in the United States and Europe. This highlights the need to focus on rare diseases and orphan drugs and for policies to be created in SA to attract pharmaceutical markets and fulfill unmet orphan drug approval needs.

Colorectal cancer-related resource utilization and healthcare costs in Saudi Arabia.

Background: Recently, there has been an increase in the incidence of colorectal cancer in Saudi Arabia. Although numerous studies worldwide have investigated the economic burden of colorectal cancer the information specific to Saudi Arabia remains limited. While advanced cancer treatments offer substantial benefits, they they also come with substantial financial challenges. Objective: This study aimed to estimate the economic burden of colorectal cancer and identify the primary cost drivers. Method: This retrospective, single-center cost of illness study examined all patients with colorectal cancer from January 2017 to December 2020. This study used a micro-costing, bottom-up approach to estimate healthcare resource utilization and direct medical costs associated with colorectal cancer. Result: The study included 326 patients with colorectal cancer. The total direct medical cost for all patients were $19 million, with an annual cost per patient of $58,384. Medication costs were the primary driver of healthcare spending (45%) of the total cost, followed by surgical costs (27%). This study explained cost associated with colorectal cancer, which represents a significant cost to the Saudi healthcare budget. The expected growth and aging of the population and availability of costly treatments may lead to an increase in costs. These findings are valuable for healthcare policymakers seeking to comprehend the economic challenges posed by colorectal cancer.

Current status and vision of local pharmaceutical industries in Saudi Arabia: The focus on nanomedicines.

Background: Pharmaceutical nanomedicine products are expected to impact the global pharmaceutical market and healthcare system significantly. Since 2000, the Food and Drug Administration (FDA) and European Medicines Agency (EMA) have approved over 80 nanomedicine products for marketing; an additional double that number is currently being tested in clinical trials. The nanomedicine market is expected to reach USD 350.8 billion by 2025 from USD 138.8 billion in 2016. This demonstrates the importance of nanotechnology to the delivery of pharmaceuticals. The main benefits of employing nanotechnology to distribute therapeutic agents include reducing the undesired toxicity from non-specific distribution and increasing patient adherence, which can indirectly minimize the burden on the country's healthcare system. Such products are expected to gain a significant economic impact on Saudi Arabia's pharmaceutical drugs market once they get developed locally. Method: A descriptive and cross-sectional study, including a web-based questionnaire and a complete categorization of pharmaceutical products formed by the national industries in Saudi Arabia, was utilized to investigate the current and future direction of pharmaceutical manufacturing exploiting nanotechnology in the Kingdom. Results: The survey showed an apparent lack of willingness within the national pharmaceutical industries, as the majority (≈ 86%) of the leading Saudi companies cannot enable nanotechnology-based medicines in their manufacturing. However, more than 93% of the national pharmaceutical industries, upon the basis of the responses, agreed that the development of pharmaceutical products with nanotechnology is an important step toward solving various complications associated with conventional forms of the available medicine. Conclusion: National pharmaceutical industries in Saudi Arabia will need to get closer to manufacturing nanomedicines by partnering with international pioneer companies. In addition, empowering the local research and development (R&D) centers in nano delivery systems could facilitate translating their R&D outcomes into novel advanced and commercialized products. This could imitate the direction of the global pharmaceutical market and share its revenue which will positively reflect on the Kingdom's economy.

Cost-effectiveness of Ribociclib in HER2- negative breast cancer: A synthesis of current evidence.

Background: The main aim of this study was to investigate the cost-effectiveness of Ribociclib in the treatment of patients with breast cancer by assessing the published evidence. Method: A systematic review of the published literature was conducted to identify the economic evaluations/cost-effectiveness study of Ribociclib. In this study, several databases were inspected, including PubMed, NHS Economic Evaluation, Cochran, and Scopus. Studies were eligible if they assessed the cost-effectiveness of Ribociclib and reported incremental cost-effectiveness ratio (ICER). The study was performed and conducted following the PRISMA reporting guidelines. Results: Of 70 studies identified, 8 articles meet our inclusion criteria. The cost-effectiveness threshold varied from $24,144.18 in Spain to $198,000/QALY in the USA. Moreover, the result demonstrated that the mean ICER varied across different countries $1,863.47/QALY in Spain and $813,132/QALY in the USA. Conclusion: Among all CDK4/6 inhibitors medications, current evidence indicated that the use of Ribociclib for HER2- negative breast cancer management was beneficial and considered to be cost-effective. Future research is needed to investigate the role of Ribociclib in long-term treatment.

Appropriate therapeutic drug monitoring of antibiotics contributed to lower nephrotoxicity
.

OBJECTIVE: The main objective of this study was to evaluate therapeutic drug monitoring (TDM) services for antibiotics and investigate the association between non-adherence to TDM guidelines and development of nephrotoxicity. MATERIALS AND METHODS: This retrospective study was conducted using electronic health records of hospitalized patients who received antibiotics for which TDM was requested over a 1-year period. Adherence to TDM guidelines was measured by reviewing appropriate indications, sampling times, result reporting, and clinical pharmacist interventions. RESULTS: A total of 1,179 patients (65% males), for whom TDM was requested during 2017 were included. Upon an assessment of the appropriateness of sampling times, we found that ~ 15% of samples were drawn at the wrong time, and in over 46% of the cases, TDM service was inconsistent with guidelines. Further, although physicians accepted the majority of pharmacists' interventions related to the TDM service, the pharmacist did not provide any recommendation in more than one-third of the cases. Nephrotoxicity was the most common adverse reaction and was observed in 19.5% of the patients. Furthermore, we found a significant correlation between nephrotoxicity and non-adherence to TDM guidelines (OR = 1.47; p = 0.014). Our study shows that adherence to the guidelines and implementation of an appropriate and effective TDM service for antibiotics increases the number of patients with adequate plasma levels, optimizes clinical outcomes, and minimizes toxicities. Moreover, there was a strong association between non-adherence to the TDM guidelines and development of nephrotoxicity. CONCLUSION: The findings suggest that adherence to TDM guidelines not only improves clinical practice but also contributes to the reduction of the cost associated with the development of nephrotoxicity.

Polypharmacy and comorbidities among ambulatory cancer patients: A cross-sectional retrospective study.

INTRODUCTION: Polypharmacy is prevalent among cancer patients; however, its relationship with comorbidities as well as its other potential factors has not been well studied among this segment of the patient population. Although several studies have described the prevalence of polypharmacy in cancer patients, its prevalence among Middle Eastern cancer patients is largely unknown. Therefore, the aim of this study is to assess the prevalence of polypharmacy among ambulatory cancer patients as well as its association with comorbidities. METHODS: A cross-sectional study using patients' electronic health records was conducted among ambulatory cancer patients aged ≥ 18 years in a tertiary care hospital. Polypharmacy was defined as the cumulative use of five or more medications. The main outcome was to assess the factors related to polypharmacy among ambulatory cancer patients which was evaluated using a multivariable binary logistic regression model. RESULTS: A total of 383 ambulatory cancer patients were included. Of these, approximately 79% had polypharmacy. Polypharmacy was more likely among patients with hypertension (AOR = 3.24; 95% CI: 1.41-7.42), diabetes (AOR = 3.33; 95% CI: 1.39-7.98), asthma (AOR = 8.64; 95% CI: 1.64-45.54), and anxiety (AOR = 3.61; 95% CI: 1.72-7.57). CONCLUSIONS: Polypharmacy is highly prevalent in the Saudi Arabian oncology patients, especially in those with comorbidities like hypertension, diabetes, anxiety and asthma. Because polypharmacy mostly goes hand in hand with comorbidities, therefore, a multidisciplinary team approach of oncology pharmacist working with other healthcare providers to manage polypharmacy and simplify drug regimens for cancer patients is warranted to optimize the healthcare quality and improve drug safety.

Pharmacy students' attitudes toward patient safety in Saudi Arabia: a cross-sectional study.

BACKGROUND: There is a growing recognition of the importance of teaching patient safety to medical students to improve healthcare and minimize patients' harm; however, few studies evaluated the attitudes of pharmacy students toward patient safety. The purpose of this study was to explore the attitudes toward patient safety among pharmacy students in Saudi Arabia. METHODS: A cross-sectional study was conducted among pharmacy students from four different universities using a self-administered questionnaire. The Attitudes to Patient Safety Questionnaire III (APSQ-III) was used to measure the attitude toward patient safety. The data were presented using descriptive statistics, such as percentages and means, and compared across gender using Student's t-test. RESULTS: All of the students who agreed to participate and signed the consent form have completed the questionnaire. Of the 347 pharmacy students who participated in the study; 63% were enrolled in the Doctor of Pharmacy Program and 37% were enrolled in the Bachelor of Pharmaceutical Sciences program. Only 46% of the participants received courses for patient safety mainly in the fourth year of their pharmacy program, and around 93% were interested to learn more about patient safety. A more positive attitude toward patient safety was reported in the domain of 'confidence to report errors', 'working hours as error cause', 'patient involvement in reducing error', and 'team functioning'. However, most negative attitudes were reported in the domains of 'Error inevitability' and 'Disclosure responsibility'. Gender differences were noticed in the attitude toward patient safety; female students had more positive attitudes in most domains of patient safety. CONCLUSIONS: Around one-half of the surveyed pharmacy students did not receive any courses on patient safety. Our findings emphasize the need for including patient safety courses in the curricula of the different pharmacy programs given the patient safety training importance in improving the quality of patient care.

Pharmacy students attitude and perception toward working in community pharmacy in Saudi Arabia.

OBJECTIVE: The objective of this study is to determine the level of attitude and perception of Saudi pharmacy students toward working in community pharmacies after graduation and to assess cultural, educational, and job related barriers and limitations that interfere with students and community pharmacy as a favorable workplace. METHODS: A cross sectional questionnaire, was mailed to a random sample of 600 pharmacy students. It included questions on students' future careers, ideal environment and barriers that might face them in community pharmacy. RESULTS: Four hundreds and twelve (412) completed the survey (response rate was 69%). Mean age was 23 years and 51.2% of respondents were female. Our results revealed low responses toward how interested they are to work in community pharmacy. The study response showed that improvement in salary and money incomes (46%) and culture and society issue (45%) are the two main barrier to make the career in community pharmacy more attractive. CONCLUSIONS: Saudi pharmacy students had a negative attitudes and insufficient knowledge about community pharmacy. Pharmacy school would have an important role to fill the knowledge gap and prepare the student to work in the community pharmacy. In order to successfully "Saudization" the community pharmacy setting, efforts should be made to overcome their perceived barriers.

The burden of bites and stings management: Experience of an academic hospital in the Kingdom of Saudi Arabia.

PURPOSE: The main aim of this study is to estimate the economic burden and prevalence of bites and stings injuries in Saudi Arabia. METHODS: A retrospective, cross-sectional study was conducted at King Saud University Medical City (KSUMC) for all bites and stings cases presented to the Emergency Department (ED) between the period June 2015 and May 2019. RESULTS: A total of 1328 bites and stings cases were treated in the ED at KSUMC. There were 886 insect bites and stings cases, 376 animal bites, 22 human bites, 34 scorpion stings, and ten snakebites. Most cases were reported in April - June. Females account for 62% of the reported cases, and the mean age was 24 years old. The total management cost of bite and sting cases during the study period was 3.4 million Saudi Riyal (SR). The spending cost of the management of animal bites was the highest as it cost 1,681,920.76 SR, followed by insect's management costing 1,228,623.68 SR. CONCLUSION: Bites and stings have a considerable health care burden on our society. Although the vast majority of the cases were not associated with a severe life-threatening condition, many were visit ED and associated with high medical costs. Increased awareness of the hazards of animal-related injuries, especially during spring and summer, where most cases take place may lower its incidence and decrease EDs visits.

Drug utilization and expenditure of anticancer drugs for breast cancer.

PURPOSE: Drug utilization studies have proven to be an effective tool in the evaluation of rational drug use in different health care systems, including oncology. The drug utilization studies were used in many institutes to ensure the safe, effective and appropriate use of drugs being prescribed. The main aim of this study was to assess the utilization pattern of anticancer drugs in breast cancer patients. METHOD: A retrospective cross-sectional observational study was carried out at King Saud University Medical City (KSUMC) for 1 year from January 2016 to December 2016. All female patients diagnosed with breast cancer during this year were included in the study. RESULTS: A total of 101 patients were included in this study. Most patients received an average of three anticancer drugs. The most commonly prescribed medication was fluorouracil, epirubicin, and cyclophosphamide (FEC) regimen, which was used in 81% of patients. Combinations of FEC + docetaxel and FEC + docetaxel + trastuzumab were received by43% and 23% of patients, respectively. Docetaxel was the most commonly used drug in neoadjuvant setting, whereas letrozole and trastuzumab were prescribed more frequently in hormonal and targeted therapies, respectively. The total drug expenditure on anticancer therapy was approximately 3.8 million Saudi Riyals (S.R), with adjuvant therapy constituting over half of the total spending. In neoadjuvant settings, the spending cost for hormonal therapy was the highest. The condition of most breast cancer patients was improved during the study period, whereas only 29% of the included patients progressed. CONCLUSION: FEC was the most common regimen used in this study, consistent with the National Comprehensive Cancer Network (NCCN) guideline recommendation. Our results indicated that adherence to a clinical guideline and recommended medication regimens improved patient outcomes. Our finding indicate how analyzing drug utilization pattern could benefit institutions in managing inventory and efficiently using health care resources.

Assessing the pharmacy students' knowledge of common medical terms after a curricular change in Saudi Arabia.

Medical terminology is the vocabulary used to describe the human body and its conditions; fluency in this language is essential for health care professionals. We examined the level of basic medical terminology understanding among 347 pharmacy students in four different colleges of pharmacy in Saudi Arabia using a newly developed test of 30 multiple choice questions. Students in the relatively new colleges of pharmacy were more likely to have a higher score in the medical terminology test compared to their counterparts from the old college of pharmacy (ß = 1.23, 95% CI = 0.16-2.30, P-value = 0.02). Female gender (ß = 1.72, 95% CI = 0.57-2.88, P-value = 0.003), and advanced class level (ß = 0.84, 95% CI = 0.36-1.32, P-value < 0.001) were also positively associated with high medical terminology test scores. The findings of this study reveal a deficiency in the pharmacy students' level of understanding of basic medical terms which may necessitate a reintroduction of the medical terminology course into the pharmacy curriculum.

Exploring the value of a Doctor of Philosophy program in Pharmaceutical Outcomes and Policy Research in Saudi Arabia.

BACKGROUND: The need for graduate education in Pharmaceutical Outcomes and Policy Research (POPR) is becoming increasingly apparent worldwide. However, the number of professionals in this field is inadequate in the Middle East. Therefore, this study aimed at gaining insight into the perceived value of a potential Doctor of Philosophy (Ph.D.) program in POPR among different stakeholders in Saudi Arabia. METHODS: Following the development of a Ph.D. program structure in POPR, a questionnaire was created to explore the perception of its value among decision-makers in different healthcare and governmental institutions. An email with detailed information on the proposed program was sent to 131 identified individuals along with an online link to the questionnaire. RESULTS: Responses were provided by 107 (81.67%) individuals. The majority of respondents (53.3%) represented large organizations with more than 500 workers; hospitals and academia were the most represented types of institutions. More than 85% of the participants strongly agreed that the program will meet the needs of the healthcare market in Saudi Arabia and that there will be a demand for graduates of the program over the next 5-10 years. However, only 28.04% of the participants declared that they would definitely recommend the program to their colleagues and employees, and 49.53% would consider employing its graduates. CONCLUSIONS: The obtained results indicate a significant interest among different stakeholders in introducing a Ph.D. program in POPR in Saudi Arabia.

Drug utilization and cost associated with inflammatory bowel disease management in Saudi Arabia.

BACKGROUND: There has been an increase in incidence and prevalence of inflammatory bowel disease (IBD) outside the western countries. Treatment costs are an essential component for healthcare planning and priority setting. The utilization patterns and annual administration and cost of IBD medications are largely unknown in countries with an increasing incidence of disease, Saudi Arabia being an example. AIM: To evaluate the use of non-biologic and biologic agents and their associated annual administration costs in a sample of patients with Crohn's disease (CD) and ulcerative colitis (UC) in Saudi Arabia. METHODS: Single-center retrospective chart review was performed to determine the use of biologic and non-biologic medications among IBD patients in a tertiary care hospital in Riyadh, Saudi Arabia. Daily and the annual acquisition cost of different IBD therapeutic agents was calculated. The utilization rates and cost of each type of medication by CD and UC patients were compared. RESULTS: Data of 258 CD patients and 249 UC patients were analyzed. Infliximab and adalimumab were the most commonly prescribed biologics among the study sample, however, their utilization rates were significantly higher among CD than UC patients (36.82% vs. 11.24%, and 20.54% vs. 9.64%, respectively, P < 0. 01). Azathioprine utilization rate was also higher among CD patients compared to their UC counterparts (71.71% vs. 40.16%, respectively, P < 0.01). However, the utilization rate of mesalazine in the UC patients was significantly higher than their CD counterparts (85.53% vs. 14.34% for CD, P < 0.01). The annual cost of biologics (including administration and lab test cost) ranged from 5572 USD for ustekinumab to 18,424 USD for vedolizumab. On the other hand, the annual cost of non-biologics ranged from 16 USD for prednisone to 527 USD for methotrexate. CONCLUSION: Biologics are extensively used in the management of IBD, particularly CD, and their utilization costs are significantly higher than non-biologics. Future studies should examine the cost effectiveness of IBD medications especially in countries with increasing incidence such as Saudi Arabia.

Factors associated with glycemic control in type 2 diabetic patients in Saudi Arabia.

OBJECTIVE: To identify factors associated with glycemic control in type 2 diabetes mellitus patients in tertiary academic hospital. RESEARCH DESIGN AND METHODS: This was a retrospective cross-sectional study of adults with type 2 diabetes mellitus. Data were extracted from the electronic health record (EHR) database for the period from 1st of January to 31st of December 2016. Participants were considered to have a glucose control if the HbA1c level was less than 7% [53 mmol/L]. Descriptive analysis and multivariable logistic regression model were performed to assess the factors associated with glycemic control. RESULTS: A total of 728 patients were included in the study for which (65%) were female, and about 60% of the sample size was between 45 and 60 years old. Multivariate logistic regression model showed participants older than the age of 65 were less likely to have controlled diabetes compared to the younger participants (OR: 0.53 [CI: 0.30-0.93]). Moreover, those who had hypertension (OR: 0.61 [CI: 0.43-0.86]) and dyslipidemia (OR: 0.53 [CI: 0.38-0.74]) were less likely to have controlled diabetes, while those with asthma (OR: 2.06 [CI: 1.16-3.68]) were more likely to have controlled diabetes. The model also showed that vitamin D deficiency was not associated with glycemic control in type 2 diabetes patients (OR 0.80 [95% CI 0.58-1.12]). CONCLUSION: These findings highlighted the need for appropriate management in older adult patients to prevent the complication of type 2 diabetes. Furthermore, attention should be exercised for patients with factors associated with poor glycemic control such as hypertension and dyslipidemia.

Measuring the quality and completeness of medication-related information derived from hospital electronic health records database.

OBJECTIVE: Electronic Health Records (EHRs) database is a great source for pharmacoepidemiological research as thousands of patients' clinical and medication information is stored in the database. However, the use of EHRs database for research purposes depends greatly on the accuracy and completeness of the data being used. This study mainly aimed to assess the completeness of EHRs patients' medication-related information. DESIGN: A retrospective cross-sectional study using data extracted from the EHRs database was conducted. SETTING: The EHRs data was obtained from a single tertiary hospital in Saudi Arabia. MAIN OUTCOME MEASURES: The completeness of data was measured considering if a patients' record contains all desired types of data (i.e., patients' demographics, clinical diagnosis, and medication-related information). RESULTS: A total of 23,411 unique individuals were identified after extracting the data from the EHRs. The study found that 89.9% of the patients had a complete data (i.e., age, gender, marital status, nationality, encounter type, and clinical diagnosis). Further, 83.1% of the patients had complete medication-related information. Subgroup analysis by the encounter type indicated that the data was 91.0% complete for outpatient encounter and 93.2% complete for inpatient encounter. CONCLUSION: The study findings indicate that the completeness of the data varies by the desired types of data. EHRs can be a potentially great resource to conduct research to assess medication use. Further studies focusing on the content and completeness of EHRs for a specific patient population and evaluate other dimensions of EHRs data quality are needed.

Efficacy of acetaminophen versus ibuprofen for the management of rotator cuff-related shoulder pain: Randomized open-label study.

BACKGROUND: Shoulder pain related to the rotator cuff (RC) is one of the most common and bothersome musculoskeletal complaints. Pharmacologic treatment most often includes acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. However, data allowing comparison of the efficacy of these two drugs are very limited. We compared the therapeutic outcomes of acetaminophen and ibuprofen in the management of RC-related pain. METHODS: This was an open-label, two-center, active-control, prospective randomized clinical trial. Participants were assigned randomly to acetaminophen or ibuprofen treatment groups. The acetaminophen dose was 500 mg every 6-8 h, and it was 400-800 mg every 6-8 h for ibuprofen. The impact of the treatment was measured by Shoulder Pain and Disability Index (SPADI), Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaires at baseline and after 6 weeks of therapy. RESULTS: Thirty-three patients completed the study; 20 treated with ibuprofen and 13 with acetaminophen. Patients in both groups were comparable at baseline with regard to SPADI, Quick-DASH, and WHOQOL-BREF scores. After 6 weeks of treatment, patients receiving ibuprofen, but not acetaminophen, reported an improvement in pain severity and functional activity (as measured by SPADI and Quick-DASH). Patients taking acetaminophen, but not ibuprofen, reported improvement in the physical and environmental domains of WHOQOL-BREF scores. CONCLUSIONS: Ibuprofen and acetaminophen provide benefits to patients suffering from RC-related pain. However, the type of improvement perceived by patients differed between these two medications.

Changes in the utilization of osteoporosis drugs after the 2010 FDA bisphosphonate drug safety communication.

INTRODUCTION: In October 2010, the US Food and Drug Administration (FDA) issued a safety communication regarding the risks of atypical fractures of the femur, with bisphosphonates drugs. This study evaluated the impact of the bisphosphonates FDA safety communication on the utilization of osteoporosis medications in Medicaid programs. METHODS: Osteoporosis drugs utilization data from the July 2006 to June 2014 were extracted from the national Summary Files from the Medicaid State Drug Utilization Data maintained by the Centers for Medicare & Medicaid Services (CMS). We performed an interrupted time series analyses to evaluate trends in utilization of osteoporosis drugs before and after the 2010 FDA safety commination. RESULTS: Time-series analyses of osteoporosis drug utilization in Medicaid program revealed a significant downward trend associated with the 2010 FDA bisphosphonates safety communication. Before the FDA safety communication was issued, the utilization rate was slightly decreased between 2006 and 2010. In the year following the FDA safety communication the bisphosphonate DDDs per 1000 beneficiaries of fell 22% yearly until the end of study period. CONCLUSIONS: The 2010 FDA bisphosphonates safety communication appeared to have influenced Osteoporosis utilization in Medicaid recipients. The 2010 FDA bisphosphonates safety communication was associated with a significant reduction in the utilization of bisphosphonates in the Medicaid program.

The patterns of children poisoning cases in community teaching hospital in Riyadh, Saudi Arabia.

INTRODUCTION: Although the majority of poisoning-related cases can be managed in home settings, reduction of hospital visits and admissions are still important challenge. Thousands of interventions are involved and the appropriate management of poisoning is therefore a major task and burden to any institution. Therefore, the present study was aimed to identify the most common classes of toxic substances and route of poisoning in children and to investigate the pattern of drug and chemical poisoning in suspected case fatalities, the subsequent need for hospital admission and arrival time to hospital. METHODS: A retrospective cross-sectional descriptive study of all registered poisoning cases of children reported to drug and poison information center at King Khaled University Hospital Riyadh, Saudi Arabia during the period of January 2010-December 2016. RESULTS: A total of 735 children presented to Pediatric Emergency Medicine with poisoning. Most of the cases were asymptomatic, and majority of children were arrived to the hospital in less than 3 h. The drugs were the most common cause of poisoning (70%) followed by chemical materials (29%), which is more common in children under 2 years comparing to other groups (p < 0.001). The route of poisoning was oral in the majority of cases (98.8%). The drugs most frequently ingested were analgesic (18.8%). Among the chemicals, pesticide products involved in (39.6%) of the cases, followed by cleaning products (25.9%) and cosmetic (22.8%). CONCLUSION: The results found that the majority of poisoning cases occurred in children under the age of six and required only observation without treatment. These results necessitate the need for close cooperation between different governmental health-sectors to establish national epidemiological surveillance of poisoning events in Saudi Arabia to help to develop national plans to decrease the financial burden of emergency department congestion and hospital crowding.

Relationship between health literacy and body mass index among Arab women with polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) puts patients at higher risk for obesity and diabetes. Poor health literacy is also associated with these conditions. Notably, weight loss is associated with improved ovulation and pregnancy rates for women with PCOS. In this study the association between health literacy and body mass index (BMI) among women with PCOS was examined. METHODS: The health literacy of women with PCOS was measured using the Arabic version of the single item literacy screener (SILS) at a university medical center. Sociodemographic and medical information was collected by interviewing the participants and reviewing their medical records, respectively. The relationship between health literacy and BMI was assessed by multiple logistic regression analysis. RESULTS: Health literacy was assessed in 127 women with PCOS from September 2015 to February 2016. Only 16.54% of participants had limited health literacy. The mean BMI for all participants was 30.57 (kg/m2), and the mean age was 27.40 years. Further, most of the participants (74%) had a high school diploma or a higher degree. Almost 56% of the participants were taking metformin, and 11.81% had hypothyroidism. After controlling for age, education, hypothyroidism diagnosis, and the use of metformin, participants with high BMI were 10% less likely to have a good health literacy level (OR = 0.904; 95% CI = 0.829-0.987; P = 0.0238). CONCLUSION: Improving the health literacy of patients with PCOS may have a positive impact on their BMI and eventually lead to favorable health outcomes.